Serax

trademark for preparations of oxazepam, an antianxiety agent.

oxazepam

(ox-az-e-pam) ,

Novoxapam

(trade name),

Oxpam

(trade name),

Serax

(trade name) Pregnancy Category: D

Indications

Action

Pharmacokinetics

Time/action profile (sedation)

ROUTE	ONSET	PEAK	DURATION
PO	45–90 min	unknown	6–12 hr

Contraindications/Precautions

Adverse Reactions/Side Effects

Central nervous system

• dizziness (most frequent)
• drowsiness (most frequent)
• confusion
• hangover
• headache
• impaired memory
• mental depression
• paradoxical excitation
• slurred speech

Ear, Eye, Nose, Throat

• blurred vision

Respiratory

• respiratory depression

Cardiovascular

• tachycardia

Gastrointestinal

• constipation
• diarrhea
• drug-induced hepatitis
• nausea
• vomiting
• weight gain (unusual)

Genitourinary

• urinary problems

Dermatologic

• rashes

Hematologic

• leukopenia

Miscellaneous

• physical dependence
• psychological dependence
• tolerance

Interactions

Drug-Drug interaction

Additive CNS depression with other CNS depressants, including alcohol, antihistamines, antidepressants, opioid analgesics, and other sedative/hypnotics (including other benzodiazepines ).May ↓ the therapeutic effectiveness of levodopa.Hormonal contraceptives or phenytoin may ↓ effectiveness.Theophylline may ↓ sedative effects.Concomitant use of kava-kava, valerian, skullcap, chamomile, or hops can ↑ CNS depression.

Route/Dosage

Availability (generic available)

Nursing implications

Nursing assessment

• Assess patient for anxiety and orientation, mood and behavior.
• Assess level of sedation (ataxia, dizziness, slurred speech) periodically throughout therapy.
• Assess regularly for continued need for treatment.
• Prolonged high-dose therapy may lead to psychological or physical dependence. Restrict the amount of drug available to patient.
• Geriatric: Assess CNS effects and risk of falls. Institute falls prevention strategies.
• Lab Test Considerations: Monitor CBC and liver function tests periodically during prolonged therapy.
  • May cause decreased thyroidal uptake of sodium iodide ¹²³I and ¹³¹I.

Potential Nursing Diagnoses

Anxiety (Indications)
Ineffective coping (Indications)
Risk for injury (Side Effects)

Implementation

• Medication should be tapered at the completion of therapy (taper by 0.5 mg q 3 days). Sudden cessation of medication may lead to withdrawal (insomnia, irritability, nervousness, tremors).
• Oral: Administer with food if GI irritation becomes a problem.

Patient/Family Teaching

• Instruct patient to take oxazepam exactly as directed. Missed doses should be taken within 1 hr; if remembered later, omit and return to regular dosing schedule. Do not double or increase doses. If dose is less effective after a few weeks, notify health care professional.
• Inform patient that oxazepam is usually prescribed for short-term use. Encourage patient to participate in psychotherapy to address source of anxiety and improve coping skills.
• Encourage patient to participate in psychotherapy to address source of anxiety and improve coping skills.
• Teach other methods to decrease anxiety, such as increased exercise, support group, relaxation techniques.
• May cause drowsiness or dizziness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
• Advise patient to avoid the use of alcohol and to consult health care professional prior to the use of OTC preparations that contain antihistamines or alcohol.
• Advise patient to notify health care professional of medication regimen prior to treatment or surgery.
• Advise patient to inform health care professional if pregnancy is planned or suspected.
• Emphasize the importance of follow-up exams to monitor effectiveness of medication.
• Geriatric: Instruct patient and family how to reduce falls risk at home.

Evaluation/Desired Outcomes

• Decreased sense of anxiety.
  • Increased ability to cope.
• Prevention or relief of acute agitation, tremor, and hallucinations during alcohol withdrawal.